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From Tehran to Dallas Jafar Forghani, MD Internist-Rheumatologist Iran University of Medical Sciences (IUMS) Tehran, Iran March 17, 2006. Jafar Forghani,MD. Born in Abadan, Iran 1945 MD degree from Isfahan Medical school: 1963-1970

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slide1

From Tehran to Dallas

Jafar Forghani, MD

Internist-Rheumatologist

Iran University of Medical Sciences (IUMS)

Tehran, Iran

March 17, 2006

jafar forghani md
Jafar Forghani,MD
  • Born in Abadan, Iran 1945
  • MD degree from Isfahan Medical school: 1963-1970
  • Internship @ Malden Hosp.,Malden, MA: 1973-1974
  • Medical residencies +

Rheumatology fellowship

@ Cleveland Clinic, Cleveland, OH: 1974-1978

  • Prof. of medicine , Dep. Internal Med

Head, division of Rehumatology

@ IUMS: 1978- present

  • Member: Iranian Board of Internal Medicine

Iranian Board of Rheumatology

Iranian Rheumatology Association

from tehran to dallas
From Tehran to Dallas
  • Iran & Tehran
  • Medical schools in Iran
  • Internal medicine & rheumatology in Iran
  • Iran University of Medical Sciences (Tehran)
  • Examples of patients and quizzes for medical residents
  • Sabbatical study in Dallas
iran persia
Iran-Persia

The Aryans came about

2000 BC and split

into two main groups,

the Medes and the Persians.

The Persian Empire founded (c.550 BC) by Cyrus the Great.

It was succeeded, after a

period of Greek and Parthian rule, by the Sassanid in the early 3d century (AD).

Iran (Eran, Arynam, land of Aryans)

slide5

Achaemenid Empire(500 B.C.)

The Achaemenid Persians of central Iran ruled an empire which

comprised Iran, Mesopotamia, Syria, Egypt, and parts of

Asia Minor and India from the 6th to the 4th century B.C.

slide6

The Achaemenids ceremonial capital was Persepolis in southern Iran

founded by King Darius the Great (522-486 B.C.)

slide7

XPa Trilingual 1

Gate of Xerxes

North Door Jamb, West Doorway

| Elamite Inscription | Old Persian Inscription | Akkadian Inscription |

slide8

Cyrus II = Cyrus(Koresh) the great

Length: 22.86 cm

Cyrus Cylinder

This cylinder has sometimes been described as the 'first charter of human rights'

slide9

Text of the declaration(Cyrus Cylinder)

I am Cyrus, King of Persia, great king,

mighty king, King of Babylon, king of the land of Sumer and Akad,

King of ......, king of the four quarters of Earth,

son of Cambysis (Kambujiye), great king, king of Anshan,

grandson of Cyrus (Kurosh),

slide10

Text of the declaration(Cyrus Cylinder)

As to the inhabitants of Babylon who against the will of the gods

were enslaved,

I abolished the corvee which was against their social standing,

I freed all slaves.

I brought relief to their dilapidated housing, putting thus an end

to their misfortunes and slavery

slide11

Now that I put the crown of kingdom of Iran, Babylon,

and the nations of the four directions on the head with

the help of (Ahura) Mazda, I announce that

I will respect the traditions, customs and religions of the nations

of my empire and never let any of my governors and subordinates

look down on or insult them until I am alive.

I never let anyone oppress any others,

and if it occurs , I will take his or her right back and penalize the oppressor.

And until I am the monarch, I will never let anyone take possession of movable and landed properties of the others by force or without compensation.

Until I am alive, I prevent unpaid, forced labor.

slide12

Text of the declaration(Cyrus Cylinder)

To day, I announce that everyone is free to choose a religion. People are free to live in all regions and take up a job provided that they never violate other's rights.

No one could be penalized for his or her relatives‘ faults.

I prevent slavery and my governors and subordinates are obliged to prohibit exchanging men and women as slaves within their own ruling domains.

Such a traditions should be exterminated the

world over ......

slide13

Persepolis was burned by Alexander the great in 331 B.C.

Only the columns, stairways, and door jambs of its great palaces survived the fire.

The stairways, adorned with reliefs representing the king, his court, and delegates of

his empire bringing gifts, demonstrate the might of the Persian monarch.

slide14

Perspolis – 600 miles south of Tehran

The Achaemenids ceremonial capital was Persepolis in southern Iran

founded by King Darius the Great (522-486 B.C.)

slide16

IRAN: Persepolis - Portico of the "Hundred-columned Hall" of Darius (ca. 520 B.C.). The body of a colossal bull from the gateway can be seen at the lower left.

slide17

U.S.A.: Chicago - Colossal bull head from Persepolis, as restored and installed in the Iranian Hall of the Oriental Institute Museum

slide18

Area:1.648 million sq km

Slightly larger than Alaska

Land boundaries:

total: 5,440 km

Border countries: Afghanistan 936 km, Armenia 35 km, Azerbaijan-proper 432 km

Azerbaijan-Naxcivan exclave 179 km,

Iraq 1,458 km,

Pakistan 909 km,

Turkey 499 km, Turkmenistan 992 km

Population: ~ 70 million

slide19

Milad Tower: Tehran

Azadi Square: Tehran

Tehran Population: 10 to 12 millions

slide28

Isfahan (Esfahan)= half the world

Naghsh-e-Jahan (Shah) square

slide32

Tehran University : 1934

Iran University of Medical Sciences: 1974

internal medicine in iran
Internal Medicine in Iran
  • 4 year program > 3 y. program > 4 y. program
  • Admission through national entrance exams
  • Promotion by universities evaluations + national exam
  • Board eligible internists get license to practice
  • National Board of Internal Medicine
  • Board certified internists may go to subspecialty programs or employed as medical staff in universities
  • Currently there are 7 approved subspecialty programs: Card., Endo., GI., Hem-Onc., Nephro., Pulm., and Rheum. (Infectious disease – straight from MD)
slide34

Morning Report

Internal Medicine

Hazrat Rasool Hospital

rheumatology in iran
Rheumatology in Iran
  • Fellowship programs started in 1983
  • 2 years clinical programs in 5 centers

( 3 in Tehran, 1 in Shiraz, and 1 in Mashad)

  • Admission through national entrance exams (written and oral)- 11 positions each year
  • Subspecialty Board of Rheumatology exam after completion of 2 years fellowship
slide56

A 32 year old female with 12 years

history of SLE (malar rash, + ANA

+Anti DNA, GN,arthritis) was

admitted to hospital for treatment

of sever thrombocytopenia.

She had been on prednisolone 5 mg t.i.d,

Chloroquine 150 mg/day and Azathioprine 50 mg b.i.d. for last 3 years.

She was treated with 3 pulses of Methylprednisolone 1000 mg/day followed by daily plasmaphresis via a Jugular vein catheter for 2 weeks and then 3 time/week for next 3 weeks.

She has had pain of right hip on walking since 5 years ago. The X-ray of pelvis on admission is shown.

slide58

She developed fever( up to 104 ) 6 weeks after admission . Jugular catheter was removed and IV antibiotics started.

One week later, she complained of severe pain in right hip. She was not able to stand or walk. Right hip was in external rotation position and all movements were painful.

The X-ray of pelvis at this time is shown.

slide60

Interpret X-rays. What is your diagnosis?

X-ray 7 weeks later

X-ray on admission

sabbatical study
Sabbatical study
  • 3 months @ Arthritis Consultation Center ,

Presbyterian Hospital of Dallas

  • To observe design, and process of clinical trials on biologic agents for treatment of rheumatoid arthritis and other rheumatic diseases.
  • To observe implementation of medical residency curriculum at PHD.